Step 1
Take the stitch with a standard needle holder, leaving a 1-2in short tail on
the needle entry side. grasp the needle end of the suture with an assisting
forceps about 3-5in from the operative site to fix the suture. Trap the suture
under the upper jaw of the Easy-Knot device about 1.5in from the point of suture
fixation.
Step 2
Use the assisting forceps to wrap the suture around the Easy-Knot device
twice, distal to the upper jaw (preferably going first under the device rather
than over it).
Step 3
Bring both instruments closer to the short tail and hold the tail with the
lower jaw of the Easy-Knot device. Open the upper jaw to release the trapped
suture and pull the device (holding the suture tail) and the assisting forceps
(holding the needle suture end) in opposite directions (relative to initial
positions) to establish a first half-hitch. Cinch and tighten as needed.
Step 4
Repeat the procedure to form additional half-hitches, making sure to reverse
the direction of pulling on the suture ends to establish a square knot. For
instance, if the short end starts on the right side of the incision, it should
end on the left side after the first half-hitch, and again on the right side
after the second half-hitch.
